Case report: Atypical presentation of visceral leishmaniasis: Two cases from northwest ethiopia

Abstract

Human visceral leishmaniasis (VL) is a life-threateningdisease caused by protozoan parasitesbelonging to the Leishmania donovani complex. Atypical cases of leishmaniasis and HIV coinfection have been documented in case reports, mostly associated with gastrointestinal tract, kidney, and skin involvement. We report two VL cases with atypical localizations not reported fromeastAfrica before, both diagnosed and treated at the LeishmaniasisResearch and TreatmentCenter, Gondar, Ethiopia. The first casewas an HIV-infected patientwith scrotal and penile involvement. Leishmania parasiteswere detected in the spleen and the scrotum. The second case was an immunocompetent individual with esophageal, laryngeal, and pharyngeal involvement and facial lesions. Leishmania parasites were detected in the spleen, skin, and esophageal biopsies. Current evidence suggests atypical presentation can occur in patients irrespective of their HIV status. Therefore, we suggest a high index of suspicion for VL among clinicians working in endemic areas of Ethiopia.